Ambulatory assessment in panic disorder and specific phobia.

Abstract

Anxiety disorders are among the most prevalent mental disorders. In panic disorder, panic attacks often occur at unpredictable times, making it difficult to study these episodes in the laboratory. In specific phobias, symptoms occur in very circumscribed situations and specific triggers are sometimes difficult to reproduce in the laboratory. Ambulatory assessment, or ecological momentary assessment, can further the understanding of the natural course and scope of symptoms under ecologically valid circumstances. Because bodily symptoms are integral to the diagnosis of anxiety disorders, the objective assessment of physiological responses in the patients' natural environment is particularly important. On the one hand, research has highlighted intriguing discrepancies between the experience of symptoms and physiology during panic attacks. On the other hand, it has validated symptom reporting during therapeutic exposure to phobic situations. Therefore, ambulatory assessment can yield useful information about the psychopathology of anxiety disorders, and it can be used to monitor change during clinical interventions.

Instability of physical anxiety symptoms in daily life of patients with panic disorder and patients with posttraumatic stress disorder

“…Ambulatory assessment of symptom instability by means of electronic diaries seems a valuable addition to clinimetric approaches when assessing phenomena like the sequence of symptoms, the rate of progression of illness, severity of comorbidity, and other aspects of daily life that are subject to change across time. Hopefully, the use of new technologies such as ecological momentary assessment will not only be beneficial in the area of research but also in therapeutic settings, for monitoring symptoms in the natural environment of patients and assessing responses to treatment (see Alpers, 2009;Maheu, Pulier, Wilhelm, McMenamin, & Brown-Connolly, 2005;.…”

Ambulatory Assessment

“…For example, a special section on AA approaches appeared in Psychological Assessment in 2009 (Trull & Ebner-Priemer 2009), including articles focused on substance use disorders (Shiffman 2009), anxiety disorders (Alpers 2009), mood disorders and mood dysregulation (Ebner-Priemer & Trull 2009), and psychosis (Oorschot et al 2009). Haedt-Matt & Keel (2011) provided a meta-analysis of studies using AA to address the affect regulation model of binge eating.…”

CUE: The continuous unified electronic diary method

“…In addition, because electronic diaries contain automatic timestamp information for entries, they allow researchers to monitor and assess participant entries for compliance and reliability (Ebner-Priemer & Trull, 2009). Electronic diaries, sometimes referred to as ecological momentary assessment or ambulatory assessment, are now increasingly used by researchers investigating psychological phenomena such as emotional functioning, mood disorders, stress, organizational behavior, and health treatments (Alpers, 2009;Gunthert, Conner, Armeli, Tennen, Covault, & Kranzler, 2007;EbnerPriemer et al, 2007;Ebner-Priemer, & Sawitzki, 2007;Fahrenberg, Myrtek, Pawlik, & Perrez, 2007;Myrtek, Aschenbrenner, & Brugner 2005;Hoppmann & Riediger, 2009;Jamison et al, 2001;King, Lluch, Stubbs, & Blundell, 1997;Klumb, Elfering, & Herre, 2009).…”